Institute of Hygiene, Microbiology, and Environmental Medicine, Austria.
Institute of Hygiene, Microbiology, and Environmental Medicine, Austria.
Clin Microbiol Infect. 2015 Jun;21(6):569.e1-7. doi: 10.1016/j.cmi.2015.02.012. Epub 2015 Feb 20.
Antibiotic resistance patterns of more than 120 000 clinical Escherichia coli isolates were retrospectively analysed. Isolates originated from both hospitalized patients and outpatients from the region of southeast Austria from 1998 to 2013. Except for amoxicillin/clavulanic acid, nitrofurantoin and piperacillin/tazobactam, all of the antibiotics analysed showed increasing proportions of resistant isolates over time, which were most prominent for ampicillin (from 25.4% in 1998 to 40% in 2013), cefotaxime (0.1% to 6.7%), ceftazidime (0.3% to 14.2%), ciprofloxacin (4.3% to 16.7%) and trimethoprim/sulfamethoxazole (14.6% to 24.8%). There was a marked increase in extended-spectrum β-lactamase-positive isolates (0.1% to 6.3%) starting in 2005, with male patients and hospital-related patients showing a higher increase than female patients and outpatients. Proportions of resistant isolates for most antibiotics were generally higher for male patients and hospital-related patients. Amikacin, nitrofurantoin and trimethoprim/sulfamethoxazole showed a marked increase in resistance proportions among male subjects aged 10 to 19 years which were absent for female subjects, indicating a strong modulation potential of host characteristics.
对 12 万多例临床大肠杆菌分离株的抗生素耐药模式进行了回顾性分析。这些分离株来自奥地利东南部地区 1998 年至 2013 年的住院患者和门诊患者。除阿莫西林/克拉维酸、呋喃妥因和哌拉西林/他唑巴坦外,所有分析的抗生素在过去的时间里耐药分离株的比例都在增加,其中氨苄西林(1998 年的 25.4%增加到 2013 年的 40%)、头孢噻肟(0.1%增加到 6.7%)、头孢他啶(0.3%增加到 14.2%)、环丙沙星(4.3%增加到 16.7%)和复方磺胺甲噁唑(14.6%增加到 24.8%)的耐药比例最为显著。从 2005 年开始,产超广谱β-内酰胺酶阳性分离株(0.1%增加到 6.3%)显著增加,男性患者和医院相关患者的增加率高于女性患者和门诊患者。大多数抗生素的耐药分离株比例在男性患者和医院相关患者中普遍较高。阿米卡星、呋喃妥因和复方磺胺甲噁唑在 10 至 19 岁男性中耐药比例显著增加,而女性中则没有,这表明宿主特征具有很强的调节潜力。